Decreased Newborn Size following COVID-19 Infection during Pregnancy: The Role of Timing of Infection

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Abstract The objective of this study was to examine the effect of coronavirus disease 2019 (COVID-19) infection during pregnancy on birth outcomes, including the relationship between the trimester of COVID-19 infection and newborn size. Findings could be used to better inform appropriate management of COVID-19 during pregnancy. This retrospective chart review study included patients diagnosed with COVID-19 who received care at a single university-affiliated obstetrics practice. Pregnant patients with a diagnosis of COVID-19 between April 2022 and April 2023 were included in this study. Participant demographics and birth outcomes were extracted and analyzed. Our sample included 141 women who had COVID-19 during pregnancy, grouped based on the trimester of COVID-19 infection. In analyses adjusted for confounding background factors, those with a COVID-19 infection during the second trimester (n = 57) and third trimester (n = 50) had newborns with significantly decreased head circumference at birth compared with those infected during the first trimester (p < 0.05). In addition, compared with those with a COVID-19 infection during the first trimester, those who had COVID-19 during the third trimester had an average 1.3 cm decreased birth length. In the current study, COVID-19 infection later in pregnancy, especially in the third trimester, significantly predicted decreased birth weight, length, and head circumference.

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